High school diploma or GED required
The Charge Posting Specialist is responsible for maintaining information related to payment and adjustment entry as well as accounts receivables and collections. The Charge Posting Specialist is responsible for managing, directing and supervising reimbursement. The Charge Posting Specialist is responsible for the overseeing and processing of all NCH Physician Group professional charges and the collection of delinquent patient accounts.
The Charge Posting Specialist will work, as a Team with the Patient Service Representatives to assure data entry is accurate and complete. At all times, this Associate will conduct their work efforts with the ultimate goal of providing high quality, efficient service for the patients and payors of NCH Physician Group.
ESSENTIAL DUTIES AND RESPONSIBILITIES – Other duties may be assigned.
Assure pre-certifications are obtained when required. Properly document pre-certification information.
Facilitate the preparation and processing of daily charge documents including hospital charges.
Prepare daily bank deposit, checks are to be deposited the day they are received. Submit Close to designated accounting personnel. Ensure control groups are balanced at end of each day.
Monitor all insurance edit reports, making any necessary corrections and re-filing corrected charges promptly.
Answer patient and insurance company inquires and concerns in a courteous and professional manner. Provide approximate fees for upcoming tests and arrange payment plans. Document all conversations and actions in the computer under the "notes" section of the patient's account, always follow-up on your work in this area.
Monitor revenue and accounts receivable status on a daily basis. Audit co-payment and patient responsibility collections by measuring collections at Check-Out on a daily basis.
Verify account balances and refund appropriate party for overpayment and incorrect payments or transfer credit to appropriate outstanding balance per NCH Physician Group policy. Enter note in patient's account of refund check amount and check date. Forward refund requests to Controller for check processing.
Generate Requests for Review from the insurance pending/AR status claims and balances over 60 days old. Utilize this information to work these accounts on a routine basis accordingly to NCH Physician Group collection policy.
Determine which accounts should be referred to Collections based on NCH Physician Group collection policy then forward accounts to collection.
Review all insurance Explanation of Benefits and all billing correspondence for denials, trends, and payment errors making necessary corrections to insure payment.
Keep current on all CPT and ICD-9 changes/issues and insurance/contractual updates that effect reimbursement. Attend 95% of NCH Physician Group billing meetings and 1 to 2 outside billing webinars per year.
EDUCATION, EXPERIENCE AND QUALIFICATIONS
High school diploma or GED required. College degree preferred.
- Minimum of 1 or more years of documented Medical Billing/Collection Experience preferred.
Basic accounting knowledge and skills.
Excellent communication skills – both verbal and written
Computer experience with PC/Unix environment preferred.
Knowledge of CPT and ICD-9 codes – evidence of updated education.
Knowledge of Medical Terminology.
Proven self-starter with ability to motivate personnel.
Knowledge of insurance ability and billing Procedures preferred.
NCH Physician Group is a technologically advanced group medical practice which uses electronic medical records, the ability to understand and utilize a Windows-based environment is essential.